History of Neurology at Stanford

The Department of Neurosurgery at the Stanford University
School of Medicine has distinguished itself in clinical care and
research in neuro-oncology, pediatric neurosurgery, stem cell
research, and many other areas. But did you know that teaching and
training in neurosurgery at Stanford can be traced back to San
Francisco in the 1890s at Cooper Medical College, the predecessor
institution to Stanford's School of Medicine? The exhibit is now
on display on the first floor of Lane Medical Library, near the
main entrance. This is the first in a new series of exhibits on
the history of the Departments and programs in the Stanford
University School of Medicine that will be featured in Lane
Library.

Professor Macewen delivered five masterly lectures on
surgical anatomy in relation to neurological function, based
almost entirely on his original research.

Neurosurgery involves the diagnosis and treatment of disorders
related to the spinal column, spinal cord, brain, nervous system
and peripheral nerves. The development of its practice at Stanford can be seen as part of
the broader history of medicine in California.

Surgeons and physicians numbered among the thousands who arrived
in California during the Gold Rush of the late 1840s and early
1850s. In the succeeding decades, The San Francisco Medical Press
and The Pacific Medical & Surgical Journal reported
trephination being used to treat railroad workers, soldiers,
miners and others for epilepsy, cranial fractures and gunshot
wounds.

Among the faculty of Cooper Medical College in San Francisco,
which became Stanford
University’s school of medicine in 1908, Dr. Levi Cooper Lane
outlined trephination in his major textbook on surgery, and Dr.
Henry Gibbons performed brain and spine operations on soldiers
while serving in the Civil War.

On the East Coast, Dr. Henry Cushing inaugurated the modern field
of neurosurgery in the early 20th century. His students
transferred the nascent discipline to California — including
Dr. Edward Towne, who brought Cushing’s teachings to Stanford. Within the first half
of the 20th century, neurosurgeons established a national
professional organization, a certifying board, and a journal.

1858–1895

Foundations

In 1858, San Francisco surgeon Elias Samuel Cooper opened the
first medical school in the western United States. After his early
death, his nephew Levi Cooper Lane revived the school and named it
“Cooper Medical College” in his uncle’s honor. After Stanford University took over the
college in 1908, it became the Stanford
University School of Medicine.

Like his uncle, Levi Cooper Lane was a surgeon; and he
published a major textbook on head and neck surgery. Surgery was
not highly specialized in the 19th century, however, and
neurosurgery was undeveloped as a discipline. Brain surgery in
Lane’s textbook largely amounted to trephination.

In 1895, Lane instituted a new
special course of lectures to be delivered at the beginning of
each term at Cooper Medical College. For the inaugural course,
Lane selected Dr. William Macewen, Regius Professor of Surgery in
the University of Glasgow, Scotland to offer presentations on
brain surgery. Lane wrote:

"Professor Macewen delivered five
masterly lectures on surgical anatomy in relation to neurological
function, based almost entirely on his original research.

The lectures were models of excellence in
every particular and were listened to with reverent attention by
the students and faculty of Cooper Medical College, and by a large
number of physicians, some of whom came from long distances, even
from the states of Oregon and Nevada."

1895–1920

Harvey Cushing and his Legacy

Modern neurosurgery was pioneered by Harvey Cushing, who received
his MD from Harvard Medical
School in 1895 and did his residency under the guidance of William
Halsted at Johns
Hopkins.

Given Cushing’s interest in surgical neurology, Halstead sent
Cushing to study under leading surgeons in Europe — though
Cushing missed his opportunity to meet with William Macewen in
Glasgow. Cushing devoted himself exclusively to the development of
surgical neurology.

His efforts were recognized by 1919, when after Cushing’s
address to the American College of Surgeons, William J. Mayo
announced,

"Gentlemen, we have this day witnessed
the birth of a new specialty — neurological surgery."

Edward Towne had received his MD from Harvard Medical School in 1913.
After studying under Cushing and serving in World War I, he
accepted the offer by Stanford
for the position of Instructor in Surgery beginning in 1920.
He held the position of Visiting Surgeon not only at Stanford
University Hospital in San Francisco, but also at the San Francisco
City and County Hospital (now San Francisco General
Hospital) and the now-defunct Southern Pacific Hospital.

1920–1944

Emergence of a Field

At the time that Edward Towne started teaching at Stanford in 1920, neurosurgery had
begun to develop as a professional specialization — a trend
that would continue over the next quarter century.

In 1920, the Society of
Neurological Surgeons held its first meeting under the direction
of Harvey Cushing at Brigham
Hospital in Boston. Initially, the few members of the society met
primarily to learn from one anothers’ surgical innovations. Edward
Towne was a participant.

Also in 1920, another future Stanford
faculty member, Frederick Reichert, was awarded his MD at Johns Hopkins. For two years
at Hopkins, Dr. Reichert studied neurosurgery under Cushing’s
successor, Walter Dandy. Dr. Reichert accepted the position of
Associate Professor of Surgery
at Stanford in 1926, and served as Professor of Surgery from 1930
until his retirement in 1960. During the years 1942–45, Dr.
Reichert served as Department
of Surgery Acting Executive while Dr. Emile Holman served in World
War II.

Within two years, the Harvey Cushing Society limited its membership
those who were certified by the American
Board of Neurological Surgeons. In 1944, the Journal of
Neurosurgery was established, further consolidating the field.

1945–1989

John Hanbery and a New Division of Neurosurgery

John W. Hanbery received his MD from Stanford
in 1945, after which he was accepted to do a neurosurgery residency
at Johns Hopkins under
Harvey Cushing’s protégé, Walter Dandy. Due to Dr. Dandy’s passing
in 1946, however, Dr. Hanbery instead pursued a residency in
neurosurgery at McGill University under Wilder Penfield and William
Cone.

Dr. Hanbery’s concerted efforts resulted in the establishment of a
residency training program in neurosurgery at
Stanford in 1961. Three years later, the Department of Surgery created
a new Division of
Neurosurgery, and Dr. Hanbery served as the first Executive Head.
Former residents who trained under Dr. Hanbery honored his
mentorship in 1974 when they created the John W. Hanbery Society,
which continues to meet annually for the presentation of research
and clinical papers. Dr. Hanbery retired in 1989.

1990–Present

A New Department of Neurosurgery

Dr.
Gary Steinberg has served as Chair of the Department since 1996.
The Department has been particularly distinguished in terms of
developing subspecialty expertise, both clinically and
academically, and with regard to education of residents and
postdoctoral fellows.

Areas of clinical and research focus include :

cerebrovascular surgery and stroke

brain tumors and neuro-oncology

pituitary tumors and disease

spine surgery

pediatric neurosurgery

functional neurosurgery (movement disorders, pain,
epilepsy)

traumatic brain and spinal cord injury

stem cell research

clinical outcomes research and non-invasive and minimally
invasive surgery, including radiosurgery and endovascular surgery